Obesity is a significant public health concern in America, and for many, bariatric surgery offers a life-changing solution. However, navigating insurance coverage for these procedures can be complex and frustrating. This article focuses on the self-pay option for weight loss surgery, specifically laparoscopic sleeve gastrectomy, in Tennessee, providing a detailed breakdown of costs, financing options, and considerations.
Laparoscopic Sleeve Gastrectomy: A Popular Choice
Laparoscopic sleeve gastrectomy is one of the most popular weight loss surgeries in the United States today. It involves surgically removing a portion of the stomach, creating a smaller stomach sleeve or tube that is roughly the size and shape of a banana. This restriction in stomach size leads to reduced food intake and subsequent weight loss. The procedure is also believed to affect gastrointestinal tract hormones responsible for control of hunger and diabetes. Patients with a body mass index (BMI) greater than 35 may qualify for laparoscopic sleeve gastrectomy.
The Challenges of Insurance Coverage
Not all insurance plans cover bariatric surgery. And, the process to meet the qualifications for coverage can be lengthy. Even when insurances cover weight loss surgery, they may not pay for all expenses related to the surgery. While many insurance providers offer bariatric coverage, the policyholder of your plan (typically your employer) may have chosen to exclude this coverage. If you have an “exclusion” or do not have coverage for weight loss surgery, your insurance will not pay for your surgery. The bariatric surgery insurance approval process can be challenging and confusing. It generally takes anywhere from 3 to 9 months to complete the pre-approval process before you can proceed with the surgery because most insurance companies require physician-supervised weight loss attempts, psychological evaluations, and evidence that your primary care physician supports you getting the surgery.
Self-Pay Option: A Faster Route
For those without insurance coverage, or for those who wish to expedite their bariatric surgery process, the self-pay option offers a faster route to bariatric surgery. Self-pay is an option if your insurance policy doesn’t cover the surgery or you don’t meet their requirements. This option speeds up the process for when you can have the surgery because qualification requirements are less stringent. With this option, you can have a consultation with me right away and begin planning for your surgery.
Self-Pay FastTrack Requirements
The self-pay option is less strict because insurance companies use outdated data based on riskier open bariatric surgeries in the ‘80s and ‘90s. Minimally invasive surgeries today, like laparoscopic or robotic-assisted, are much safer. Therefore, patients don’t have to be as sick to outweigh the risks of surgery. To qualify for the Self-Pay FastTrack option for either gastric bypass and gastric sleeve, you must meet these requirements:
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- BMI ≥ 35
- History of failed dietary attempts
- No unstable or untreated mental illness
- Not a smoker or willing to quit smoking prior to surgery
- Commitment to life-long medical surveillance
- At least 16 years of age
Self-Pay Laparoscopic Sleeve Gastrectomy in Knoxville, TN
The Premier Surgical Surgery Center in Knoxville, TN now offers self-pay outpatient laparoscopic sleeve gastrectomy for appropriate candidates. The procedure is performed by Premier Bariatric Surgeons, Dr. Mark Colquitt of Foothills Weight Loss Surgeons and Dr. K. Robert Williams of New LIfe Center for Bariatric Surgery. If you are an appropriate canddiate, Dr. Colquitt can perform the Sleeve Gastrectomy procedure at the outpatient Premier Surgery Center on Papermill Drive in Knoxville. The $12,850 price includes the surgeon, facility, anesthesia and basic BLIS insurance coverage for complications. For an additional $500 expanded BLIS coverage is also available.
Cost Breakdown at Premier Surgical Surgery Center
The Premier Surgery Center package price for sleeve gastrectomy is $12,500. This includes the surgeon, facility, anesthesia, and BLIS insurance coverage for complications.
Cost Considerations at New Life Center for Bariatric Surgery
If you’re an appropriate candidate, Dr. Williams can perform the Sleeve Gastrectomy procedure on an outpatient basis. The price starts at $13,000. Please note: not all patients will qualify for same-day surgery. Patient eligibility depends on whether you meet the health critera required for a safe outpatient surgery.
Understanding What Self-Pay Surgery Includes
As a self-pay patient, you’ll receive an upfront, all-inclusive cost after your initial consultation-no hidden fees or surprises!
The Importance of Education and Support
Our Premier bariatric surgeons want patients to completely understand the bariatric surgery process. That’s why new patients are required to watch a bariatric seminar and attend pre-surgery education. People are the most successful in their weight loss journey when they commit to long term necessary lifestyle changes. Doing this alone can be tough. Dr. Colquitt and Dr. Williams and their teams continue to monitor their patients’ progress on an ongoing basis. After surgery, bariatric patients will have check-ups at monthly and yearly intervals.
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Financing Options for Self-Pay
At our Center, we recognize that investing in your health is a significant decision, and we’re dedicated to making it accessible. To support your weight loss journey without added financial stress, we offer a variety of flexible financing options. With our FastTrack program, you can expect to have surgery within 3-4 weeks after you decide to move forward.
Available Financing Methods
Some patients may choose to borrow against their 401k plan or utilize a home equity line of credit. However, if you need assistance with financing your surgery, we work with several leading healthcare finance companies like Prosper Healthcare Lending, Lending USA and CareCredit. New Life Center for Bariatric Surgery will soon be offering CareCredit, a flexible financing option for patients. The CareCredit credit card makes it easy to pay for gastric sleeve surgery and related expenses not covered by health insurance.** Use our Acceptance Locator to find a doctor or cosmetic surgeon near you that accepts CareCredit so you can stop dreaming and start living your best life. In addition to cosmetic procedures, you can also use your CareCredit credit card for dentistry, pet care, vision, hearing, health systems, dermatology, pharmacy purchases, spa treatments and so much more within the CareCredit network.
Tax Deductions and Healthcare Spending Accounts
The IRS allows taxpayers undergoing weight loss surgery to deduct expenses for procedures, approved weight-loss drugs, and nutritional counseling. Deductions are allowed for uncompensated expenses of treatment of an individual if the cost is more than 7.5 percent of adjusted gross income. Talk to your tax professional or CPA about how tax deductions can help you and your weight loss surgery process. Some or all of the costs associated with a weight loss program may be reimbursable if you have a healthcare spending account (FSA/HSA). Check first with your account administrator about your eligible expenses. Some services, supplements, or medications may require a letter of medical necessity.
Package Inclusions at Nashville Weight Loss Solutions
Gastric Sleeve: $17,500 (total cost) Both packages include:
- Pre-surgical testing including radiology and blood tests
- Surgeon, anesthesia, and hospital fees
- A lifetime of post-operative visits with Dr. Houston
- Lifetime access to our registered dietitians, exercise physiologist, and Psychological Support Program
- BLIS Care of complications related to surgery for 90 days after the procedure
BLIS Reinsurance
At New Life Center for Bariatric Surgery, we have insurance coverage for bariatric pre-pay patients that covers the cost of most major complications should one occur. BLIS reinsurance is included in your surgical weight loss program. New Life Center for Bariatric Surgery is proud to be affiliated with BLIS. Becoming a BLIS surgeon is a very selective process as determined exclusively by BLIS. This means that Dr. K. ** The standard BLIS complication protection is exclusively part of the Package Price you will pay for your weight loss surgery. Because we are a Center of Excellence for bariatric surgery, BLIS Care covers complications in the first 90 days after surgery. With BLIS Care, patients feel comfortable financing their surgery knowing that they are covered should a rare complication arise.
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What to Expect After Surgery
A typical laparoscopic sleeve gastrectomy patient can expect to spend one night in the hospital and be on a liquid diet for the first week following surgery and gradually progress to soft proteins then solid food. Solid food can usually be introduced back into the diet around six weeks postsurgery.
Potential Complications and Considerations
- Dumping Syndrome: Dumping syndrome occurs when the digestive tract has been shortened, causing more rapid movement of food from the stomach to the small intestine.
- Pregnancy: Yes, it is possible to get pregnant after gastric sleeve surgery. Weight loss surgery may even help your chance of conceiving.
- Vitamin B12 Deficiency: Chronic anemia due to Vitamin B12 deficiency may occur. The portion of the stomach that produces ghrelin, the hormone responsible for appetite and hunger, is removed.
Contact Information
- Nashville Weight Loss Solutions: Contact Nashville Weight Loss Solutions for more information about weight-loss surgery. If you do not have bariatric coverage and wish to proceed with the Self-Pay FastTrack Option, please complete our contact form below or call us at (615) 342-5820 to schedule a consultation with Dr. Houston.
Conclusion
Choosing to undergo weight loss surgery is a significant decision, and understanding the financial aspects is crucial. While the national average cost of gastric sleeve surgery can vary between $15,067 and $38,045, depending on the type of surgery, Tennessee offers competitive self-pay options. By carefully considering the costs, financing options, and the comprehensive support offered by various centers, individuals can make informed decisions and embark on a transformative weight loss journey.
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